Individual provider Active NPI

Benjamin Isaac Wainblat, MD

  • Family Medicine Physician
  • Davenport, WA
National Provider Identifier
1205491164
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
IMLC.MD.61566197 Issued in WA
Practice address
10 Nicholls St
Davenport, WA 99122-9729
Phone
(509) 725-7101
Fax
(509) 725-7504
NPI assigned
May 7, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IMLC.MD.61566197 WA Primary

Addresses

Primary practice location

10 Nicholls St
Davenport, WA 99122-9729

Mailing address

10 Nicholls St
Davenport, WA 99122-9729
Phone (509) 725-7501

Other practice location 1

214 SW Main St
Wilbur, WA 99185-0582
Phone (509) 647-5321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220829002173 ME Practitioner - Family Practice 1658606454 Reassigns benefits to 3 organizations
I20240815004383 WA Practitioner - Family Practice 1658606454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lincoln County Hospital District 3Group PAC ID 3971591199, shared by 5 NPIs, 21 clinicians

Practice addresses (Care Compare)

10 Nicholls St
Davenport, WA 99122-9729

10 Nicholls St
Davenport, WA 99122-9730
Phone (509) 725-7501

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
IMLC.MD.61566197WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rumford Hospital CurrentSince Jun 22, 2022 Accepting new patients
Central Maine Medical Center CurrentSince Feb 12, 2024 Accepting new patients
Lincoln County Hospital District #3 CurrentSince Aug 12, 2024 Accepting new patients
Lincoln County Hospital District 3 Family Medicine CurrentSince Aug 12, 2024 Accepting new patients
Rumford Hospital CurrentSince Jun 22, 2022 Accepting new patients
Lincoln County Hospital District #3 Family Medicine CurrentSince Aug 12, 2024 Accepting new patients
Central Maine Medical Center CurrentSince Feb 12, 2024 Accepting new patients
Rumford Community Family Health Center, Inc. Current Accepting new patients
Rumford Community Family Health Center, Inc. CurrentSince Jun 22, 2022 Accepting new patients
Lincoln County Hospital District 3 Past Accepting new patients
Lincoln County Hospital District 3 Past Accepting new patients

Locations

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

12 High St
Ste 302
Lewiston, ME 04240
Phone (207) 795-5730

430 Franklin St
Rumford, ME 04276
Phone (207) 369-0146

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

10 Nicholls St
Davenport, WA 99122
Phone (509) 725-7101

Interoperability endpoints

  • Direct secure messaging: bwainblat3373507@wm.providencedirect.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1205491164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NICHOLLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7501",
            "fax_number": "509-725-7504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NICHOLLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7101",
            "fax_number": "509-725-7504"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 SW Main St",
            "address_purpose": "LOCATION",
            "city": "Wilbur",
            "state": "WA",
            "postal_code": "991850582",
            "country_code": "US",
            "telephone_number": "509-647-5321",
            "fax_number": "509-647-2238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAINBLAT",
        "first_name": "BENJAMIN",
        "middle_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-07",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "IMLC.MD.61566197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, WA

Sources for this page

Verify at the official NPI Registry.